- Humana (Columbus, OH)
- …understanding in Medicaid programs, HEDIS and NCQA requirements. The Senior Data and Reporting Professional: + Collects, analyzes, and validates HEDIS ... caring community and help us put health first** The Senior Data and Reporting Professional generates regular...for managing and analyzing data specifically around HEDIS and quality initiatives for Medicaid . This… more
- Humana (Tampa, FL)
- …contributes to the development, implementation, and management of the company's Medicare/ Medicaid Five-Star Quality Rating System. The Senior Stars Improvement, ... Star Rating categories - including but not limited to HEDIS , Patient Safety, and Patient Experience. Senior ...Able to effectively interpret and communicate metrics and analytical data that leads to favorable outcomes. + Relationship building… more
- Centene Corporation (Jefferson City, MO)
- …expert in measure development and methodology. Defines business requirements and strategies for data capture to close risk and care gaps. + Plans and directs ... to STARS measures and, accreditation targets and Administration /Operations, Pharmacy, Clinical- HEDIS , CAHPS/HOS improvement and gap closure. + Performs root cause… more
- Humana (Oklahoma City, OK)
- …services and close gaps in care for Oklahoma Medicaid enrollees. The Senior Quality Compliance Professional has proven data analysis skills and a strong ... part of our caring community and help us put health first** The Senior Quality Compliance Professional uses quality compliance and improvement tools and methodology… more
- Evolent Health (Columbus, OH)
- …Be Doing:** The Client Analytics team offers candidates the opportunity to leverage data & analytics to drive actionable insights and strategies for our partners. We ... have a unique mix of health care domain and data expertise enabling analytics offerings relevant to our stakeholders' needs. We are advocates for creating patient… more
- CVS Health (Columbus, OH)
- …* Actively participate in meetings and communication with the State Department of Medicaid in person as needed. * Outward facing position to interact and collaborate ... insights on the clinical drivers and trends and tracks data to improve the delivery of population health care...* Be able to effectively communicate these finding to Senior Management and staff at all levels. * Develop… more
- Insight Global (Charlotte, NC)
- …following established care standards Monitor patient care quality using available data and chart reviews Assist in coordinating patient services, including specialty ... discussions with the Regional Medical Director (RMD) regarding care quality, outcome data , policies, procedures, and records Explore growth opportunities for new or… more
- Humana (Louisville, KY)
- …leader to drive innovation and strategic direction, meeting the demands for HEDIS measure performance monitoring, data interpretation, HEDIS /Stars impact ... projects or programs + Proficiency in understanding Healthcare related data + Proficiency in verbal/written communication to senior...Computer Science, Engineering or related field + Stars or HEDIS Experience + Advanced in SQL, SAS and other… more
- CVS Health (Chicago, IL)
- …personal, convenient and affordable. **Position Summary** Aetna Better Health is Aetna's Medicaid managed care plan. Backed by over 30 years of experience managing ... with a broad array of health care needs, our Medicaid plans have demonstrated that getting the right help...of the Quality team to ensure maximal performance with HEDIS and accreditations. + Serving as the SPOC on… more
- CVS Health (Mcallen, TX)
- …to helping you achieve your career goals.** **Position Summary** : The Medicaid Network State Director manages and oversees compliance with our Network ... responsibilities as provided within the State Medicaid contractual requirements as outlined below: * This Position...including using Company offices when required or requested by Senior Network Leaders. * Manages Local Provider Relations staff… more
- Molina Healthcare (Columbus, OH)
- …**Preferred Experience** + 1 year of experience in Medicare and in Medicaid . + Experience with data reporting, analysis and/or interpretation. **Preferred ... programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities;… more
- Molina Healthcare (Richmond, KY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex analyses of… more
- Conviva (Safety Harbor, FL)
- …Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating multiple centers across ... and quality for patients and monitors care using available data and chart reviews. + Assists in the coordination...in the local primary care 'on-call' program of Conviva Senior Primary Care. + Assures personal compliance with licensing,… more
- Conviva (West Palm Beach, FL)
- …Care Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country in multiple centers across eight ... and quality for patients and monitors care using available data and chart reviews. * Assists in the coordination...Medicine preferred * Active and unrestricted DEA license * Medicare/ Medicaid Provider Number * Fluent in Spanish * Minimum… more
- CenterWell (Lexington, KY)
- …Care Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating over 300 centers across ... supporting patient's physical, emotional, and social wellness. At CenterWell Senior Primary Care, we want to help those in...and quality for patients and monitors care using available data and chart reviews. * Assists in the coordination… more
- CenterWell (Las Vegas, NV)
- …Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating nearly 300 centers across ... supporting patient's physical, emotional, and social wellness. At CenterWell Senior Primary Care, we want to help those in...and quality for patients and monitors care using available data and chart reviews. * Assists in the coordination… more
- CenterWell (Dallas, TX)
- …Organization is one of the largest and fastest growing value-based care, senior -focused primary care providers in the country, operating 300 centers across fifteen ... care team supporting patient's physical, emotional, and social wellness. At CenterWell Senior Primary Care, we want to help those in the communities we… more
- Conviva (Floresville, TX)
- …level of medical care and quality for patients and monitors care using available data and chart reviews. * Assists in the coordination of patient services, including ... with RMD about quality of care, review of outcome data , policy, procedure and records issues. * Participates in...for TB **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum of two to five… more
- Conviva (Daytona Beach, FL)
- …level of medical care and quality for patients and monitors care using available data and chart reviews. + Assists in the coordination of patient services, including ... Leadership. + Meets with RMD about quality of care, review of outcome data , policy, procedure and records issues. + Participates in potential growth opportunities… more
- Conviva (Port Orange, FL)
- …of medical care and quality for patients and monitors care using available data and chart reviews.** Assists in the coordination of patient services, including but ... Leadership.** Meets with RMD about quality of care, review of outcome data , policy, procedure and records issues.** Participates in potential growth opportunities… more